Whistleblowing in academic medicine

Area of Science:

• Medical ethics
• Academic integrity
• Scientific misconduct

Background:

• Established review boards and committees in medical centers are frequently ineffective in addressing research misconduct.
• Institutional designs often ignore ethical problems, alienate whistleblowers, and fail to cultivate an ethical environment.

Purpose of the Study:

• To analyze the ineffectiveness of current mechanisms in academic medicine for addressing research misconduct.
• To illustrate the scope and seriousness of the problem through case examples.
• To propose revisions to institutional incentives to improve responses to scientific misconduct.

Main Methods:

• Discussion of cases of academic medicine failing to address unethical behavior.
• Analysis of the Olivieri/Apotex affair as an example of institutional dereliction.
• Argument for revising incentives to reframe the role of whistleblowers.

Main Results:

• Institutional designs systematically ignore ethical problems and punish whistleblowers.
• Academic medicine has a history of failing to address scientific fraud and misconduct.
• Current systems fail to protect faculty members who report unethical behavior.

Conclusions:

• Revising institutional incentives is necessary to change the current pattern of response to problematic behavior in academic medicine.
• An external realignment of incentives can transform whistleblowers from "enemies within" to valued allies.
• Correcting these incentives can encourage appropriate reactions to scientific misconduct in academic medicine.